| NPI | 1043761380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-17-30025) |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2022-06-29 |